When Is It Time to Let Go?
The sad fact of life is dog guardians tend to outlive their canine
companions and about 90% of dog owners will have to make a decision
about euthanasia.
The
word
“euthanasia” means “to bring about a good death.” The
choice to treat a medical condition or euthanize your dog is a major one – and no one wants to be wrong.
While none of us ever wants
our dog to leave us, when we wish the best for them we want a them to have a gentle
death without significant pain, suffering, fear or degradation.
It’s
also a sad fact that no amount of anticipatory grief or advance
planning - or any intellectual knowledge that you’re near the end of
your dog’s life - will save your heart from experiencing the piercing
pain of loss.
And
yet, doing some advance planning around euthanasia and death can help
you make better decisions when the time you hope never comes actually does
arrive.
First, much earlier than you think you need to -
while you have a choice and some warning, you may wish to investigate
your options and think about what your ideal situation would be. If
you’re like many Dog Friendship readers, you’ve invested a lot in your
dog’s quality of life - now it’s time for an investment in your planning
to make sure they have quality at the end of their life.
This includes pricing euthanasia, finding out if
the vet will make a home visit, checking out what happens with your dog’s
remains and what your local legislation is regarding burial (can you do
it at home? in some areas have your ashes buried with those of your
dog?) and handling your dog’s remains (most dog owners appear to prefer
to have the veterinarian take care of cremation). Checking out ahead of time what items
the vet might try to sell you is also helpful.
You’ll
also want to understand the role of both yourself and your vet in the
decision-making process. An article in the Journal of Veterinary
Behavior (2007 - 2, 35-39) noted that veterinarians are tasked
with working together with the dog owner, throughout the lifetime of the
dog, to promote the dog’s health and well-being. And that in critical
and or terminal situations, it is the veterinarian’s role to educate the
owner, so that informed decisions regarding treatment options or a
decision to euthanize your dog can take place. In veterinary medicine,
euthanasia means to end life painlessly. Veterinarians and owners,
working in partnership to make subjective and objective assessments on
your dog’s quality of life, produce the best results.
From the
veterinarian, the medical approach (including: clinical history,
physical exam, laboratory tests, diagnosis, prognosis and treatment) can
assist in assessing you in understanding your dog’s physical health
status, any potential treatments, and the likely short and long term
outcomes. Dog Friendship notes that your role in the partnership is to
subjectively assess your dog’s overall behavior changes and your dog’s
quality of life and include both this AND the veterinarians’s opinion in your decision-making.
What if your dog dies at home, before you have made a euthanasia decision or thought about post-death arrangements?
Until
decisions and preparations can be made, place your dog in the coldest
part of your home. Put plastic down and then newspaper or a blanket to
place your pet on. Cover with another towel or blanket.
You should know that dogs’
eyes remain open after they pass away. Both dogs (and people) die with
their
eyes open. This is due to a reflex that remains active even to the last
minutes
of life. In fact - the act of closing the eyes requires a special muscle
movement, and effort is required to keep them closed. Many people and
animals
pass away with their eyes open. In past centuries it was a common
practice to
hold eyelids closed by placing coins over them. The sense of sight is
generally the first to go when humans die (hearing is the last) and the
same is thought to be true of dogs.
What if your dog dies while at the vet hospital?
If
your pet dies at the veterinary hospital, you may view your dog there.
Most clinics will have a storage facility where your pet can be kept
for a day or two. Your dog belongs to you and you do have the right to take your dog home.
What options are available to me at time of loss of my pet?
You may want to consider burial
in a pet cemetery (including mausoleum burial where a casketed body is
placed in a crypt), cremation, home burial (where allowed by law), or simply having your dog’s body picked up and disposed of.
What is cremation?
Cremation
is the process of reducing matter by exposing it to intense heat. The
body is reduced to skeletal remains or cremains, embalming is not
needed. No casket is required for cremation. The organization
conducting the cremation may or may not allow you to view the
process. You can have the cremated remains returned to you (generally,
if cremation is done in a group, an id tag marks the location of the
remains and helps return the dog’s ashes to its owner). You can choose
to scatter the cremains (most areas have no restrictions on this, though
it would be useful to check with your local authorities). You may also
scatter in a special area of a pet cemetery or place the ashes in an
urn (which can be kept with you, buried or placed in an “wall” or
columbarium – an arrangement of niches erected for the sole purpose of
accepting cremains).
There are now some vendors offering a process where your dog’s body is liquified by environmentally friendly chemicals.
What kind of memorial would I like?
Some
folks prefer no memorial at all, others keep a picture nearby while
many have spoken about keeping a favourite collar or toy. Some folks
place a headstone in the yard in the dog’s favourite spot while others
use online pet memorial websites like
Rainbow Bridge
or
Peternity.
Additional Pre-planning
More questions you can do some pre-planning about include what’s important to you to have happen for your pet. If
it were within your power to provide it (and it often is), what sort of
death would you wish for your dog? Chances are, you would wish the same
death for your dog as you would wish yourself: to die when your dog is
ready, peacefully while asleep, at home, in bed, surrounded by loved
ones. Do you support euthanasia to accomplish this, or do you prefer a
natural (even if difficult) death? Making a choice now may save you
from agonizing over your decision when you are most upset. You may also
wish to consider which family members will be present during a
final goodbye, how the family members may want to say good-bye or
provide a memorial for their pet, and how and with whom they will spend
time immediately after the death or euthanasia are all important issues
which should be discussed.
When
you do find out your dog has a terminal illness, in many cases you will
have some time before the final end is due. If you receive a diagnoses
longer than two or three weeks, you may want to find out all you can
about the disease and its management. You can also learn about being
your dog’s caregiver in this challenging time - the
PawPrints Network
offers
an online forum, care journal and many resources like weight and lab
results trackers. The internet is great for research on disease and
progressions, although your vet’s education, experience and (hopefully
life knowledge of your dog) will help them interpret what the data means
for your canine friend.
You may also want to think about home-based
hospice care - providing comfortable care for a terminally-ill dog at
home is increasingly supported by vets. Hospice care, or “pawspice,” the
term coined by Alice Villalobos, DVM, former President of the American
Association of Human Animal Bond Veterinarians (AAHABV) and founding
member of the Veterinary Cancer Society, involves having a vet provide
supportive assistance in evaluating and managing your dog’s quality of
life during a time period that can span from days to months. The
International Association of Animal Hospice and Palliative Care
is a site used by both pet professionals and individuals who are care givers and offers some useful webinars that can help.
Such
care may be helpful by giving children (and adults) more time to come
to an understanding that their dog is dying, or give time for a
geograhically-distant family member to come home to say good-bye. While
sometimes families can find stressful times like a dog’s death can
create argument and division, a well-planned end and an understanding
that people can respond to life poorly when on an emotional
roller-coaster can help keep things calm – and hospice time can be a
lovely time for the family who will be left by providing mutual support
to the other family members as they start their grieving process (see
our previous blog post on
Grieving Your Dog
- the power of
listening without judgement to someone’s story of their experience with
the dog they may be losing can’t be understated). It can also be a
loving time of creating some photos of visits to special places, helping
document cherished memories. Check out this Whole Dog article on
things to monitor during hospice care
.
When Is It Time?
So
how you do you know when it’s time to call an end to your dog’s
suffering? The most common advice we’ve heard is “you will know when
it’s time”. That advice seems somehow inadequate for such a big
decision. Owners we’ve spoken to tell Dog Friendship that they are
never quite sure - and, in fact, your choice is likely imperfect. We can
never know exactly what our dog’s needs are to the moment. How much
pain is too much?
One of the things you can do
to help yourself is ask, “Does my dog have more good days than bad ones?
More good moments than bad?” Honestly assessing this question gently can
lead you to clarity about what’s happening. Sometimes we are not really looking
(probably because it hurts to look), and we may need to honestly and
objectively assess this fact before we can decide. In most cases it is fine to
simply decide to take a week and really look at what’s happening for your dog. Look for more than just a moment to get a
clear sense – maybe a few days or a week. For instance, some arthritis pain cases get
really bad after cold, wet weather. Waiting until the weather clears may result
in a totally different decision, so do be sure to give enough time to really
know.. Ask your vet to tell you if you
have enough time to do this observation.
Monitoring
your dog’s temperature, pulse and respiration can be of help here, and
can indicate significant steps in the illness. We suggest you check out
your dog’s TPR while your dog is normal and find a baseline. In
general, we suggest considering things like the shut down of major
systems like the liver and kidneys/waste disposal (confirmed by your
vet), lack of bowel movement, starvation, dehydration are vital to be
aware of. When your dog’s pain is not adequately managed with
painkillers is another sign, or when they are clearly suffering from
such cognitive dysfunction that they are not enjoying life. One hospice
specializing veterinarian uses a “HHHHHMM” scale. Dogs are scored in
each category (Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility,
More Good Days than Bad Days) on a scale of 0-10, with 10 being best. In
general, a total score of 35 or higher is considered reasonable to
maintain hospice care. The key here is to start to recognize when your
dog is starting to make their final transition and activate your plan to
ensure that your dog’s death is a kind one for you both.
It’s
also important for you to make sure you don’t let a friend, relative,
or even your vet, make the decision of exactly when to euthanize your
dog for you. This hard choice is the greatest kindness you can do for
your friend - and NO ONE knows your dog friend better than you do. You
may feel you are making a decision too soon or too late. Don’t let
anyone judge you (including yourself) if you believe the time is right
for your dog. It is more than possible to be slightly less than perfect
and still have provided your dog with what they needed most from you.
You may well be afraid of making a mistake. However,
the fear of making a mistake can actually make us more likely to make
them, so we’re actually better off if we acknowledge that fear, and at
the same time realize that this process is simply about loving our
friends and making choices based upon what is best for them. Looking and
discussing work better than worrying. Most of us make right choices
when we are given safe space, correct information and support, which
allows us time to come to a conclusion on our own.
If it is almost but not quite that time, is there something else that needs to happen for you to find more peace?
We
may want to share a few more ball catches at the beach, or watch one
last sunset together. If we can name those things and enjoy each moment,
then it may become easier to say farewell.
One owner we spoke to used the willingness to accept “the most favorite treat ever” as a barometer of when the time was right. Many
people speak of experiencing a moment where they look at their pet and
suddenly a calm silence ensues when they know it is time. The
time may well be right when your dog’s body signals an end and you know
in your heart there is nothing more that can prevent major pain and
suffering… basically when everything that care and love can do has
been done.
Dog Friendship’s vet office was amazing
during our last euthanasia. Instead of the sterile exam room floor or
table, the final minutes of the euthanasia occurred with our dog lying
on a small towel in the middle of a fluffy sheepskin. We had time in
the office to grieve and say goodbye after breathing stopped - there was
no rushing. Not long after the visit we recieved a free “cast in clay”
pawprint of our pet and a card signed by all the vet office
staff…along with a notice saying that a donation had been given to our
local pet loss hotline. A month or so later, at Christmas, a box of
cookies arrived with a note “just thinking of you over the holidays and
knowing this year is different without your dog.” While this may not be
a typical vet’s office of standard care (so don’t expect this of your
vet) the caring and support cemented our relationship and kept us loyal
clients.
Despite the sadness and emotional turmoil that your
dog’s end of life will bring, we offer a hope that with advance planning
and an understanding of what may happen you can worry less about the
details and spend more of those last quality moments focused on the
precious time with your dog. To quote
Dr. Richard
Palmquist, Chief of Integrative Health Services at Centinela
Animal Hospital,
Inglewood California in an article on euthanasia:
All living things are born, grow old and pass away.
Death is a part of living and if we concentrate on living then we have better,
happier lives. If we face death with the same sense of love and understanding
that we live our lives, then we can navigate this process and learn many things
along the way. As death comes, we are faced with the importance of relationship
and not with things. Sometimes just calmly being together is the greatest gift
of all.